Pulmonary Oedema is accumulation of fluid in lungs. It can be due to cardiogenic or non-cardiogenic causes. This presentation was a class presentation and discussed its management alongwith diagnosis.
1. B Y : D R . H A S E E B T A R I Q
Pulmonary Oedema
2. Definition
Pulmonary oedema is a condition characterized by
fluid accumulation in the lungs caused by
extravasation of fluid from pulmonary vasculature in
to the Interstitium and alveoli of Lungs.
3. The extent to which the fluid accumulation occurs in
the interstitium depends on:
Hydrostatic pressure ( favors movement into
interstitium)
Oncotic Pressure ( favors movement into
capillary)
4. CLASSIFICATION
According to cause pulmonary oedema is classified as:
Cardiogenic Pulmonary Oedema
Non Cardiogenic Pulmonary Oedema
High altitude Pulmonary Oedema (HAPE)
5. Cardiogenic Pulmonary Oedema
It is due to increased pulmonary venous &
pulmonary capillary pressure which pushes the
fluid in interstitium & alveoli.
Following are the causes:
Left Ventricle Failure
Dysrhythmia
LV hypertrophy & Cardiomyopathy
Myocardial Infarction
Left Ventricle Outflow obstruction
6. Non-Cardiogenic Pulmonary Oedema
It is caused due to following main reasons:
Direct injury to lung
Hematogenous injury to lung
Lung injury + Elevated hydrostatic pressure
14. MANAGEMENT
Give Oxygen.
Treat the underlying cause.
Respiratory support (Non-Invasive ventilation,
Intubation)
CPAP
Diuretics
Nitrates
15. High Altitude Pulmonary Oedema
Occurs in young people who ascend quickly to
2700m or above & perform strenous exercise
Reversible in nature
Low oxygen concentration at high altitudes causes
pulmonary vasoconstriction
Mean pulmonary artery pressure rises
Alveolar capillary membrane is damaged leading to
oedema
16. Signs & Symptoms:
SOB
HEADACHE
INSOMNIA
FLUID RETENTION
TREATMENT:
Rapid descent to lower altitudes & administration of
oxygen if required.
The medications Acetazolamide, Dexamethasone,
or Nifedipine may also be used for prevention.